CampfireShould my clinic start with Google ads, Facebook ads, or both?
Start with one channel, not both. If people already search for what you treat, start with Google, because that traffic has intent. If your offer is something people don't know to search for, start with Meta. Add the second channel once the first produces booked patients at a cost you can repeat, usually after four to six weeks.
Why not both at once
Running Google and Facebook together from day one sounds like covering your bases. In practice it splits a small budget two ways, so neither channel gets enough data to tell you anything. Six weeks later you have two half-answers and no idea which to turn off. Owners who have been burned by an agency often have exactly this history: everything was on, nothing was clearly working, and the report said "awareness."
One channel at a time gives you a clean read. You learn what a lead costs, what a booked patient costs, and what the front desk does with the leads when they arrive. Then you add the second channel against a number you trust.
When Google goes first
Google wins when the patient already knows what they need and is typing it in: "physical therapy near me," "knee pain specialist," "pelvic floor PT." Those people are ready to call. For most general cash-pay clinics this is the right first move. Pair search ads with a clean Google Business Profile, because the profile is where half of those clicks end up. Our article on Google Business Profile for PT clinics covers that side.
One caution from the clinics we have audited: call-only ads work for general PT and fall apart for specialty offers. If you are selling a specific program, send Google traffic to a landing page with a short form and tag it in your CRM, so you can see lead quality instead of guessing from call volume.
When Meta goes first
Facebook and Instagram win when nobody is searching for your thing yet. A running assessment, a golf mobility program, a dry needling intro, a women's health workshop: these are offers you put in front of the right person, not offers they look for. Meta is also the better first channel when you have a warm audience already, such as past patients or a local following, because reactivation on a warm list is the cheapest proof you can get before spending on cold traffic. See cash-pay patients from Meta ads for how the offer and the follow-up fit together.
How to sequence it
Pick the first channel by matching it to the offer. Run it for four to six weeks at a budget you can hold steady; starting and stopping resets the learning. Track two numbers only: cost per lead and cost per booked patient. If both are at a level you would happily pay again, hold that channel where it is and open the second one with new budget, not by moving budget away from what works. If the first channel is not booking patients, the fix is almost never the other channel; it is the offer, the landing page, or the follow-up speed, in that order.
If you already run ads on both
Don't turn anything off blind. Pull thirty days of data, find which channel is booking patients rather than generating clicks, and pause the other for a month. Owners are often surprised which one survives.
Questions around the fire
How long before I know if the first channel works?
Four to six weeks at a steady budget. Less than that and you are reacting to noise; the first two weeks of any campaign are the platform learning who to show it to.
What if I only have budget for one channel for good?
Then pick by intent. If people search for what you do, Google. If they don't, Meta. One channel done well beats two done thin.
Do I move budget from the first channel to fund the second?
No. Add new budget for the second channel. Cutting a channel that books patients to test one that might is how clinics end up with neither working.